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Joaquín Baleztena Gurrea, Physician of residency program and Professor of Geriatrics of the School of Medicine of the University of Navarra.
Indirect consequences of coronavirus in the elderly.
Little by little we are learning more about many aspects of the infection produced by SARSCoV-2, whose clinical picture has been called COVID-19 or more commonly coronavirus because the virus belongs to the Coronaviridae family.
Much is said about the direct consequences of COVID-19 on the elderly, a particularly vulnerable population in terms of severity and mortality. But there is one aspect on which little or no emphasis is being placed: the danger of geriatric syndromes that home confinement can produce in these people. Obviously, it is very important that they do not become infected and, if they do, that they get over it, but it is also essential that when all this happens they have not lost functionality and are not in worse condition than they were before.
Geriatric syndromes are a group of entities caused by the concurrence of a series of factors that are expressed through pathological conditions that are not included in the usual diseases. These can generate greater morbidity and sometimes more serious consequences than the disease itself or the initial cause that produces them.
Specifically, immobility syndrome is the common pathway of presentation of a status generated by a series of pathophysiological changes in multiple systems conditioned by immobility and accompanying disuse. It is a generally multifactorial, potentially reversible and preventable clinical picture. And of all this, the most important is the latter, since, if it is preventable and can even lead to dependence and death, we should make every effort to avoid it. The sequelae of immobility can be gradual or immediate and are more severe the longer the duration and Degree of immobilization.
In view of the above, it is vital promote that the elderly, within their confinement, lead an active life, avoiding bedridden or sitting practically all day long. Being at home does not imply staying in pajamas. It is very important that they continue with their daily routines of grooming, dressing, household chores and hobbies, and that they follow an exercise plan in accordance with their status. It is necessary to drink plenty of fluids and follow a healthy and varied nutrition, including, specifically during these days, foods rich in proteins such as meat, fish, eggs and dairy products (except in severe renal patients or special pathologies) that help, together with exercise, to build muscle training .
The family fundamentally, but also friends and neighbors, play a fundamental role here, being the greatest protective cushion at the social level that they can have. There should be no elderly person isolated at home who does not receive all the material, social, emotional and spiritual support by whatever means possible, be it daily telephone calls or controlled and individualized visits when necessary, taking advantage of the opportunity to remind them of the importance of an active life and above all humanizing their status, not limiting ourselves only to the technical and strictly sanitary measures that are taken for granted.
As we repeat so many times, in the world of Gerontology it is not only about giving years to life, but also about giving life to the years. It is everyone's duty that the elderly, when all this is over, do not become more fragile or dependent. I dare to fill in the repeated "I stay at home" with "doing active life", and without forgetting that they need more than ever our affection.